심근 기능 측정에 사용된 게이트 심근 관류 SPECT 방법의 재현성 평가: $^{201}Tl$과 $^{99m}Tc$-MIBI 게이트 SPECT의 비교 Reproducibility of Gated Myocardial Perfusion SPECT for the Assessment of Myocardial Function: Comparison with Thallium-201 and Technetium-99m-MIBI원문보기
목적: Cedars 소프프웨어를 이용한 게이트 SPECT에서 $^{201}Tl$와 $^{99m}Tc$-MIBI 게이트 SPECT 두 방법으로 측정한 좌심실 부피와 구혈률의 재현성을 비교하였다. 대상 및 방법: 휴식 $^{201}Tl$/부하 $^{99m}Tc$-MIBI 심근 관류 SPECT를 촬영한 환자 중에서 무작위로 추출된 30명은 같은 자리에서 휴식 $^{201}Tl$ 게이트 SPECT를, 26명은 부하 후 $^{99m}Tc$-MIBI 게이트 SPECT를 한번 더 촬영하였다. Cedars 소프트웨어를 이용하여 연속해 측정된 좌심실 부피와 구혈률에 대하여 표준편차의 기하학적 평균과 Bland Altman 도표를 이용한 방법으로 $^{201}Tl$과 $^{99m}Tc$-MIBI 게이트 SPECT 방법의 재현성을 각각 평가하여 비교하였다. 결과: 연속 촬영한 $^{99m}Tc$-MIBI 게이트 SPECT로 얻은 확장기말 부피와 수축기말 부피, 구혈률에 대한 Bland Altman 도해의 2 표준편차에 상당하는 범위는 14.1 ml, 9.4 ml, 5.5%로 연속 촬영한 $^{201}Tl$ 게이트 SPECT로 얻은 24.1 ml, 18.6 ml, 10.3%보다 좁았다. 또한, 연속 촬영한 $^{99m}Tc$-MIBI 게이트 SPECT로 얻은 확장기말 부피와 수축기말 부피, 구혈률에 대한 표준편차의 기하학적 평균은 2.1 ml, 2.7 ml, 2.3%로 연속 촬영한 $^{201}Tl$ 게이트 SPECT로 얻은 3.2 ml, 3.5 ml, 5.2% 보다 작았다. 결론: 같은 환자를 같은 위치에서 두번 연속하여 촬영한 게이트 SPECT로 평가한 심근기능의 재현성은 $^{99m}Tc$-MIBI게이트 SPECT 방법에서 더 우수하였다. 그러므로, 기간별 변동과 약제의 효과를 보기 위한 좌심실 부피와 구혈률 측정에서 $^{201}Tl$보다는 $^{99m}Tc$-MIBI 게이트 SPECT 방법을 선택하는 것이 더 좋을 것으로 생각된다.
목적: Cedars 소프프웨어를 이용한 게이트 SPECT에서 $^{201}Tl$와 $^{99m}Tc$-MIBI 게이트 SPECT 두 방법으로 측정한 좌심실 부피와 구혈률의 재현성을 비교하였다. 대상 및 방법: 휴식 $^{201}Tl$/부하 $^{99m}Tc$-MIBI 심근 관류 SPECT를 촬영한 환자 중에서 무작위로 추출된 30명은 같은 자리에서 휴식 $^{201}Tl$ 게이트 SPECT를, 26명은 부하 후 $^{99m}Tc$-MIBI 게이트 SPECT를 한번 더 촬영하였다. Cedars 소프트웨어를 이용하여 연속해 측정된 좌심실 부피와 구혈률에 대하여 표준편차의 기하학적 평균과 Bland Altman 도표를 이용한 방법으로 $^{201}Tl$과 $^{99m}Tc$-MIBI 게이트 SPECT 방법의 재현성을 각각 평가하여 비교하였다. 결과: 연속 촬영한 $^{99m}Tc$-MIBI 게이트 SPECT로 얻은 확장기말 부피와 수축기말 부피, 구혈률에 대한 Bland Altman 도해의 2 표준편차에 상당하는 범위는 14.1 ml, 9.4 ml, 5.5%로 연속 촬영한 $^{201}Tl$ 게이트 SPECT로 얻은 24.1 ml, 18.6 ml, 10.3%보다 좁았다. 또한, 연속 촬영한 $^{99m}Tc$-MIBI 게이트 SPECT로 얻은 확장기말 부피와 수축기말 부피, 구혈률에 대한 표준편차의 기하학적 평균은 2.1 ml, 2.7 ml, 2.3%로 연속 촬영한 $^{201}Tl$ 게이트 SPECT로 얻은 3.2 ml, 3.5 ml, 5.2% 보다 작았다. 결론: 같은 환자를 같은 위치에서 두번 연속하여 촬영한 게이트 SPECT로 평가한 심근기능의 재현성은 $^{99m}Tc$-MIBI게이트 SPECT 방법에서 더 우수하였다. 그러므로, 기간별 변동과 약제의 효과를 보기 위한 좌심실 부피와 구혈률 측정에서 $^{201}Tl$보다는 $^{99m}Tc$-MIBI 게이트 SPECT 방법을 선택하는 것이 더 좋을 것으로 생각된다.
Purpose: We compared the reproducibility of $^{201}Tl\;and\;^{99m}Tc$-sestamibi (MIBI) gated SPECT measurement of myocardial function using the Germano algorithm Materials and Methods: Gated SPECT acquisition was repeated in the same position in 30 patients who received $^{201}Tl$
Purpose: We compared the reproducibility of $^{201}Tl\;and\;^{99m}Tc$-sestamibi (MIBI) gated SPECT measurement of myocardial function using the Germano algorithm Materials and Methods: Gated SPECT acquisition was repeated in the same position in 30 patients who received $^{201}Tl$ and in 26 who received $^{99m}Tc$-MIBI. The quantification of end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) on $^{201}Tl\;and\;^{99m}Tc$-MIBI gated SPECT was processed independently using Cedars quantitative gated SPECT software. The reproducibility of the assessment of myocardial function on $^{201}Tl$ gated SPECT was compared with that of $^{99m}Tc$-MIBI gated SPECT Results: Correlation between the two measurements for volumes and EF was excellent by the repeated gated SPECT studies of $^{201}Tl$ (r=0.928 to 0.986; p<0.05) and $^{99m}Tc$-MIBI (r=0.979 to 0.997; p<0.05). However, Bland Altman analysis revealed the 95% limits of agreement (2 SD) for volumes and EF were tighter by repeated $^{99m}Tc$-MIBI gated SPECT (EDV: 14.1 ml, ESV: 9.4 ml and EF: 5.5%) than by repeated $^{201}Tl$ gated SPECT (EDV: 24.1 ml, ESV: 18.6 ml and EF: 10.3%). The root mean square (RMS) values of the coefficient of variation (CV) for volumes und EFs were smaller by repeated $^{99m}Tc$-MIBI gated SPECT (EDV: 2.1 ml, ESV 2.7 ml and EF: 2.3%) than by repeated $^{201}Tl$ gated SPECT (EDV: 3.2 ml, ESV: 3.5 ml and EF: 5.2%). Conclusion: $^{99m}Tc$-MIBI provides more reproducible volumes and EF than $^{201}Tl$ on repeated acquisition gated SPECT. $^{99m}Tc$-MIBI gated SPECT is the preferable method for the clinical monitoring of myocardial function.
Purpose: We compared the reproducibility of $^{201}Tl\;and\;^{99m}Tc$-sestamibi (MIBI) gated SPECT measurement of myocardial function using the Germano algorithm Materials and Methods: Gated SPECT acquisition was repeated in the same position in 30 patients who received $^{201}Tl$ and in 26 who received $^{99m}Tc$-MIBI. The quantification of end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) on $^{201}Tl\;and\;^{99m}Tc$-MIBI gated SPECT was processed independently using Cedars quantitative gated SPECT software. The reproducibility of the assessment of myocardial function on $^{201}Tl$ gated SPECT was compared with that of $^{99m}Tc$-MIBI gated SPECT Results: Correlation between the two measurements for volumes and EF was excellent by the repeated gated SPECT studies of $^{201}Tl$ (r=0.928 to 0.986; p<0.05) and $^{99m}Tc$-MIBI (r=0.979 to 0.997; p<0.05). However, Bland Altman analysis revealed the 95% limits of agreement (2 SD) for volumes and EF were tighter by repeated $^{99m}Tc$-MIBI gated SPECT (EDV: 14.1 ml, ESV: 9.4 ml and EF: 5.5%) than by repeated $^{201}Tl$ gated SPECT (EDV: 24.1 ml, ESV: 18.6 ml and EF: 10.3%). The root mean square (RMS) values of the coefficient of variation (CV) for volumes und EFs were smaller by repeated $^{99m}Tc$-MIBI gated SPECT (EDV: 2.1 ml, ESV 2.7 ml and EF: 2.3%) than by repeated $^{201}Tl$ gated SPECT (EDV: 3.2 ml, ESV: 3.5 ml and EF: 5.2%). Conclusion: $^{99m}Tc$-MIBI provides more reproducible volumes and EF than $^{201}Tl$ on repeated acquisition gated SPECT. $^{99m}Tc$-MIBI gated SPECT is the preferable method for the clinical monitoring of myocardial function.
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제안 방법
In a total number of 34 cases of 20lTl gated SPECT, the QGS program succeeded in automatic edge detection and to calculate the volumes and EF. Thirty patients were analyzed for volumes and EFs on two repeated 201T1 gated SPECTs, except for four patients whose ESVs were less than 30 ml.
In this study, we investigated the reproducibility of serial 201T1 and 99mTc-MIBI gated SPECT for two groups that received either of the two tracers, 201T1 or 99mTc-MIBI. And, we compared the reproducibility of 201T1 and 99mTc-MIBI gated SPECT measurement of myocardial function using Germano algorithm.
The RMS mean of CVs, Bland Altman analysis, and the coiTelation analysis of volumes and EF were performed in the same manner for the repeated sequential studies of 201T1 and 99mTc-MIBI gated SPECT.
대상 데이터
Image acquisition was performed with a tripledetector gamma camera (MultiSPECT3: Siemens, Ohio, USA) with the cardio 90 collimatorse and an electronic zoom of 1,45 provided a pixel size of 4.91 mm. Sixty projections were obtained from the left posterior oblique to the right anterior oblique over 180°, with an acquisition time of 30 sec (201Tl), or 15 sec (99mTc-MIBI) for each projection, which resulted in a total acquisition time of approximately 18 min (201Tl), or 9 min (99mTc~ MIBI).
In the randomly selected 201T1 group of 34 patients, sequential acquisitions of 201T1 gated SPECT were performed repeatedly in same position. In the randomly selected 99mTc-MIBI group of 31 patients, sequential acquisitions of 99mTc-MIBI gated SPECT were performed repeatedly in same position.
study. Patients from May to August were included in the 201T1 group, and patients from September to December in the 99mTc-MIBI group.
Patients referred for routine rest 201Tl/dipyrida-mole 99mTc-MIBI stress SPECT to assess myocardial perfusion, and viability between May and December 1999 were enrolled in this study. Patients from May to August were included in the 201T1 group, and patients from September to December in the 99mTc-MIBI group.
The other failure was caused by the presence of gall bladder uptake with low myocardial counting statistics. Twenty-six patients were analyzed for volumes and EFs on repeated 99mTc-MIBI gated SPECT, except for three patients whose ESVs were less than 30 ml.
데이터처리
Bland Altman analysis and correlation analysis were performed. The coefficients of variation (CV) of repeated sequential 201T1 and 99mTc-MIB1gated SPECT were calculated by dividing the SD by the mean of the two values.
CoiTelation of volumes and EFs between measurements made by repeated 201T1 and 99mTc-MIB1 gated SPECT were evaluated using Pearsons r value.
Differences between volumes and EFs of measurements made by repeated 201Tl and 99mTc-MIBI gated SPECT were evaluated using the paired t-test. CoiTelation of volumes and EFs between measurements made by repeated 201T1 and 99mTc-MIB1 gated SPECT were evaluated using Pearsons r value.
performed. The coefficients of variation (CV) of repeated sequential 201T1 and 99mTc-MIB1gated SPECT were calculated by dividing the SD by the mean of the two values. The root mean square (RMS) value of these CVs was calculated and used to represent reproducibility.
이론/모형
Tc-MIBI. And, we compared the reproducibility of 201T1 and 99mTc-MIBI gated SPECT measurement of myocardial function using Germano algorithm.
성능/효과
However, scatter plots showed that volumes and EF values on two repeated 99mTc-MIBI gated SPECTs were closer to regression line with 95% confidence than on two repeated 201T1 gated SPECTs. On Bland-Altman analysis, there was no evidence of any asymmetric bias between these two sequential gated SPECT with either 201T1 or 99mTc-MIBI.
On Bland-Altman analysis, there was no evidence of any asymmetric bias between these two sequential gated SPECT with either 201T1 or 99mTc-MIBI. However, the reproducibility between two sequential gated SPECTs for volumes and EF assessed by 95% limits of agreement and the RMS values of the CVs was better with 99mTc-MIBI than 201Tl. Tadamura et al.
Also, correlation was poor in the presence of significant background activity. In this study, correlation of EF was excellent between repeatedgated SPECT. We suggest that repeated acquisitions one hour after high-dose injection in this study protocol result in satisfactorial reproducibility of QGS with 99mTc-MIBI
Our results demonstrate that an excellent correlation exists between two sequential gated SPECTs with 20iT1 and 99mTc-MIBI. However, scatter plots showed that volumes and EF values on two repeated 99mTc-MIBI gated SPECTs were closer to regression line with 95% confidence than on two repeated 201T1 gated SPECTs.
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